2021-22 Lincoln Alternative Academy Student Application
Students - Please complete this student application to be considered for enrollment at Lincoln Academy. This form should be filled out by the student. All responses will be kept confidential and will be used as part of the intake / screening process for student enrollment at Lincoln Alternative Academy.
Email *
Student Last Name *
Student First Name *
Today's Date *
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Date of Birth *
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Age? *
Grade *
Living Address *
Please list the town you live in. *
Who do you currently live with? *
Your Cell Phone Number XXX-XXX-XXXX *
Parent / Guardian Last Name *
Parent / Guardian First Name *
Parent / Guardian Cell Phone #...XXX-XXX-XXXX *
Favorite Subject in School? *
Least Favorite Subject in School? *
Are you still enrolled in school? *
If you answered no, when did you last attend school? List the Month and Year. (ex. April 2020).
Where do you currently attend school? (List the name of the school and location). *
Where did you last attend school? (List the name of the school and location). *
About how many days of school did you miss last year? *
Why were you absent from school? *
Have you been placed in In-School Placement? *
If you answered yes to In-School Placement, list the reason.
Are you currently suspended from School? *
If you are currently suspended from school, list the reason and how long is the suspension.
Have you ever been suspended from school? *
If you have been suspended from school, list the reasons and for how many days.
Please check the following criteria that apply to you which should be considered for enrollment at Lincoln Academy. *
Required
If you marked "Other" on the previous question, please explain.
How did you hear about Lincoln Academy? *
If you marked family members, please list their names.
Do you know any students who attend Lincoln Academy? If so, please list their names. *
Do you currently have a job? *
If you answered yes to having a job, where do you work and for how long?
Are you currently involved in the court system? *
If you answered yes to being involved in the court system, please share information as to your involvement (ex. truancy court, etc.)
Have you ever received special services for being on an Individualized Education Plan (IEP)? *
If you answered yes to being on an IEP, what areas of support did you receive (Math, Reading, Behavior, etc.)?
Have you ever received special services for being on a 504 or Health Plan? *
If you answered yes to being on a 504 or Health Plan, why were you placed on one?
Are you interested in attending Meridian Technology Center? (Students can attend both Lincoln Academy and Meridian Technology Center). *
If you answered yes about being interested in attending Meridian Technology Center. Please list program of interest. (ex. Masonry, Culinary Arts, Digital Media, Auto Mechanics, etc.)
What are your plans after high school? *
Please share with us why you would like to attend Lincoln Academy? If there's something we did not ask and you would like for us to know, please feel free to share. (3 to 5 Sentences). *
Listed are 10 character words that Lincoln Academy uses daily to teach Life Skills. Please select at least 3 character traits you would like to improve upon yourself. *
Required
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